NCG140218 DMR SW (9)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140218 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Thomas Concrete of Carolina -Durham Plant SAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES Susan Bostian COUNTY Durham
CERTIFIED LABORATORY ESC Lab # ENV 375 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? ❑YES ®NO EMAIL:
OPTIONAL INFO: April Monitoring event DISCHARGING TO CLASS: RSA ❑HQW ❑PNA ❑Trout ®Other
Part A: Stormwater Monitoring Requirements
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on-site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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Part R• vphirlp Mnintpnanrp ortivity Mnnitnrinp Reauirements for facilities usine > 55 eal of new motor oil/month — averaeed over a calendar vear.
Outfall Date Sample
No. (Co/e �Y)
mo dd r 1
pH
(Standard
Units)
6-92
TPH using method
1664A SGT -HEM
(mg/L)
152
Total Suspended Event
Solids Duration
(mg/L) (minutes)
1002,3
Total New Motor Oil In Tier 2
a Monthly
Rainfall Usage
(in) (gal/month) Monitoring?
# of Months
in Tier 2
Sampling2
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 2
"I certify, under penalty
assure that qualified per
those persons directly re
am aware that there are
(Signature of Permittee)
1617
law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
inel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
;nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
6/8/2015
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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